The SPECIALIST'S OFFICE => Ruptured patellar tendon or ruptured quadriceps tendon => Topic started by: ambermcc1987 on January 28, 2013, 07:55:26 PM

Title: Asked to repost here --- Partial tears on BOTH my patellar ligament and the medi
Post by: ambermcc1987 on January 28, 2013, 07:55:26 PM
Cleaned this up a bit. :) If I need to take down the previous posting, please let me know.

Original injury date: December 11th 2012

Diagnosis via MRI: Partial tears on BOTH my patellar ligament and the medial patellar retinaculum. This is on top of a very painful pinched nerve in my back that I've been working through.

Current movement as of today - I don't know any degrees but I can grit my teeth and manually push my leg to where about 4 or 5 inches is below my knee when sitting on a floor.  I can't really get it to go straight not using my hands to push my leg down. I *cannot * to this day fully extend my leg without horrible horrible pain. Bending, I can sit crosslegged with pain so I'd say I can get it to bend pretty well. However, if I were to give you an approximation of movement without any or minimal 1-2 pain, then I'd say I have hardly any movement abilities.

A little about me ---  I am a 25 y/o female. Approx 140. I got the injury when rough housing with a friend. He was on top and he grabbed my ankle and on top of my thigh and pulled my ankle in and up with a bit of force.

My main concerns are these and these are what I need help with.

1..What is proper protocol for an exam?
      ------ Did I screw it up by letting him push my knee PAST where it started to hurt? I feel like a hypochondriac if I say ow… so I just stay quiet and grip whatever im on harder. My Chrio picks up on these queues easily and adjusts his sessions around it… shouldn’t the ortho be the same?
       ------Orthos out there....  What should I do in these appointments. I am getting reevaluated. Should I say Ow a lot?  Just sitting hurts, like a 3... but when I get up to walk it gets to a 5, and by the end of the day im sitting at a 9 or 10 until I can get home to ice it then as I stay off it goes back down to a 3 and starts all over again the next day. My chiro saw me yesterday and said I need to be VERY verbal when I go back but I don't want to risk my Ortho thinking im running a scam.

2. Is the Ortho’s triangle thing jabbing into my knee a better brace? Or is it hurting me more?

3. Why does it hurt LESS when I am not wearing a brace?

4. Over all things I can expect with a double PARTIAL tear….? I am baffled that I am still in so much pain even though I’ve babied it for a month.

5. Should I be looking for a second opinion since this doctor obviously isn’t taking the whole picture into account?

6. Would I be better off with surgery?
-   I feel like I’ve went through almost 2 months of pain already. If I get the surgery, then I can go through X amount and be done. I’m not even SURE if surgery is an option when it comes to the Retinaculum.

7. How long does it take to heal a double tear in a knee?

8. Lastly, can I have a shoulder to cry on? This has been horrible. I can’t stand not being able to walk without pain and the unknowns mixed with the cost is making me pretty sad.

LONG drawn out explanation of everything from injury to now.

December 11th I injured my knee. The next day I went to the ER and they took x-rays and said it was sprained. I was provided an immobilizing brace that went from mid shin to mid thigh. It looked to be a straight leg one, but I was able to use it pretty well even bending my knee. 

December 20th, I got an MRI because my Chiropractor thought my knee was more severely injured. Prognosis was Partial tears on BOTH my patellar ligament and the medial patellar retinaculum

January 3rd – First otho appointment  I advised him that I have a HUGE pain tolerance, and that when he pushed and pulled it does really hurt, im just not going to cry out or stop him.  He checked my knee. He only mentioned the tendon, and not the other tear or the pinched nerve. His prognosis – brace it and PT. 

He said that I have atrophied from being in the big brace from the 11th of December until the 4th of January.  He scheduled me for PT on 2/3 ( nearly two months post injury, seems a bit odd to me) The brace that he provided had a triangle that I place on the side of my kneecap, then the rest of the brace wraps around immobilizing the kneecap. It’s a pretty small brace.  IT HURTS! BAD BAD BAD!

I am looking online and PARTIAL tears of the patellar ligament seem to be pretty low on the pain scale as far as knees go. It seems the pain should be over.  I ice 2-3 times a day as needed. Mostly I use IB profin, but like I said occasionally I use the vicodin provided by the ER, but I cut it in half because I don’t like being loopy.  I see my Chiro 3 times a week and he does minor manipulation on it. He also uses a powerful TENS unit (electricity) on it for 15 minutes a visit.

However, I have up until today, almost two months after the injury up to level 10 pains. Usually it sits at a 5, but since im back at work its gotten A LOT worse.  I think the amount of walking is aggravating it but I don’t know what to do.

I have a distinct throbbing right on or under (can’t pinpoint) under my kneecap. Plus my whole knee area feels like it's on fire. This is pretty constant but gets HORRIBLE if I accidently straighten my leg the whole way. 
For the Medical patellar retinaculum, I can't find hardly any information on it what so ever.  I do know where it is because im having what I can only describe as sharp searing pain on that side. It's not as horrible as the top part of my knee, but it's got its moments too.

The brace the Ortho gave me makes it worse. It has a triangle piece that I put in the side of my kneecap then I wrap the brace around to hold it in place. Usually I can only keep this one on 2 to 3  hours then I switch to the one the chiro gave me. The one the chiro  gave me immobilizes the kneecap as well, but by using Velcro and straps across the top. Both braces still hurt me more than no brace at all as long as I don’t straighten my leg out.

Right now im dealing with a huge loss of income because my insurance only pays my short term disability to the earliest date that any of my doctors gave for return to work. The ortho put on my paperwork I could return the 3rd of January. However, he told me I couldn’t drive or walk long distances… I didn’t even THINK of asking him to write out what the rest of my doctors (Chiro, ER,  radiologist, and an MD) had put down. I gave his assistant a call to ask why they put the 3rd and major quotes from here were

“we don’t evaluate based off other notes” ( Read: My MRI results, Chiro notes ect)
“it’s not like you have an MCL injury, you could have went to work”
“You COULD have drove, he just didn’t want you to until you could properly hit the pedals in the car in emergency situations IE: breaking hard to avoid an accident”
“you only hurt one tendon”

So now… im at a loss. Not only have I basically been told that other things are being disregarded, but now I feel like they think I was trying to scam to get off work even though they are the ones that didn’t review the full case notes. I also found out this “Physical training” appointment they made isn’t even PT, it’s a reevaluation appointment. I am a bit offset by him… I’m not mad that he put those notes down and I lost pay; although that does sting; but I just feel like they didn’t take anything into account.

Questions at top! 

Title: Re: Asked to repost here --- Partial tears on BOTH my patellar ligament and the medi
Post by: Sara10 on February 16, 2013, 05:39:54 AM

I'm sorry to hear what happened.  Although I can't answer all the questions I'd thought I'd help.

I had an acute injury to my patellar tendon back in Nov 2012, although MRI said it wasn't torn.  I had all the symptoms of a partial tear so I know your pain.  I'm 25 and not being able to walk really took it out of me.  I would walk maybe half a block before it became unbearable and I had to sit down.   My doctor said the most important part is to keep your leg straight.  So if the brace you are talking about doesn't keep it in a straight position I would ask about that and see if you can get a brace that does.  Ice plenty.  I still am icing 3 times a day, everyday.

When will pain go away. ugh.  No doctor can answer that! It is so so frustrating, that I think I've given up asking about healing time, pain, etc.   Plus... remember that doctors see a ton of injuries, they sort of get desensitized to it what they think is a "serious" injury, even though to us.. it is!  So you absolutely have to over exaggerate everything

With me, I injured myself Nov 2nd (I only took NSAIDS the first week because frankly, they upset my stomach but thankfully I do have a high pain tolerance, which could be a bad thing) and I'm now on a week and a half of no pain!    So  3 months of pain with the first 8 weeks being the absolute worse.   Towards the last few weeks I started to noticed the pain would be there one day and then gone the next, it's started to alternate.

Because I had such a bad injury, my quad became VERY weak.  I actually lost a good cm around of muscle compared to my other quad, and the part above my knee cap became indented (weak quad).   But only when the pain stops can I start to get my quad strength back.   And I'd say I'm improving everyday.   Physical therapy is a slow process.  They are very careful.  But I'd still say it's important.  And to get a PT you likely because you will likely be seeing them a lot.  And I didn't start PT till 2 months after the injury.

Your ortho though should have at least gone over the MRI results with you.  If not, request a copy of your MRI on a disc and look at it yourself and google pictures (They should give you your MRI for free).  Not really saying to be own doctor, but sometimes it's true that you really know your own body.

Knee injuries are the worst.   It takes a lot out of you, mentally, physically, and takes a lot out of your pocket.   Counting the days to healing can be agonizing.   What I recommend is to try and keep your spirits up, read a book, watch funny movies, get a massage, and do some ab crunches while lying in bed cuz hey, that's an exercise you can do!  And know you will eventually heal!